Hafnarstræti 19, 600 Akureyri, third floor apartment 3B. Five-story reinforced concrete building constructed in 1992. Main entrance has an intercom system. Elevator and central staircase. Street parking is available. The building has a fire alarm system. Current conditions: 7°C, clear skies, good visibility. GPS coordinates: 65.6832° N, 18.0898° W. Nearest landmark: Akureyri Art Museum.
68-year-old male, experiencing severe shortness of breath. Primary symptoms: Rapid and labored breathing, use of accessory muscles, wheezing, and cyanosis around lips. Patient reports feeling extremely anxious and unable to get enough air. Secondary symptoms: Chest tightness, productive cough with yellow sputum. Patient is conscious but agitated. Skin is pale and clammy. Patient is sitting upright in a chair, struggling to breathe. Medical history: Chronic Obstructive Pulmonary Disease (COPD) diagnosed 5 years ago, hypertension, and type 2 diabetes. Medications: Salbutamol inhaler (as needed), Fluticasone/Salmeterol inhaler (twice daily), Metformin 1000mg twice daily, Lisinopril 10mg daily. Allergies: No known allergies. Last meal was lunch at 13:00, a sandwich and soup.
Timeline: 1430 hours: Patient started feeling slightly short of breath, initially dismissed it as normal COPD symptoms. 1500 hours: Symptoms worsened, patient used his Salbutamol inhaler, with minimal relief. 1515 hours: Patient reports increased difficulty breathing, chest tightness, and a productive cough. 1520 hours: Patient became increasingly anxious, cyanosis noted around lips. 1525 hours: Caller (patient's son) arrived and immediately called emergency services. 1527 hours: Current time, patient still experiencing severe respiratory distress. Prior Events: Patient had a COPD exacerbation 6 months ago, requiring hospitalization. Patient reports not having any recent infections or exposure to irritants. Last check-up was 2 months ago, routine follow-up. Patient lives with his wife, son lives nearby.
Initial Impression: Acute COPD Exacerbation with Respiratory Distress Justification for F2 Classification: - Patient presenting with severe respiratory distress, cyanosis, and use of accessory muscles. - High risk of respiratory failure if not promptly treated. - Time-sensitive condition requiring immediate medical intervention. Differential Diagnoses: 1. Acute COPD Exacerbation (high probability) 2. Pneumonia (less likely, no fever reported) 3. Pulmonary Embolism (less likely, no sudden onset of symptoms) 4. Acute Heart Failure (less likely, no history of heart failure) Required Actions: - Dispatch of ground EMS with ALS capabilities. - Oxygen therapy initiation. - Bronchodilator administration. - Preparation for transport to nearest hospital with respiratory services.